Quick Facts :
Nurse Practitioners

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Bureau of Labor Statistics, Nurse Practitioners, May 2017

info-icon Master's Degree
info-icon $110,930 Annual Wage
info-icon 31% Job Growth

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What Is a Psychiatric Nurse Practitioner?

A psychiatric nurse practitioner may operate their own practice in addition to offering private consulting services to other companies, communities, and medical organizations. As an advanced practice registered nurse (APRN), the psychiatric nurse practitioner holds either a graduate or a doctorate degree in mental health nursing. This foundational knowledge allows him or her to diagnose and treat those with mental health issues as well as to identify specific risk factors that can make an individual vulnerable to developing a mental illness later in life.

In addition to working directly with patients and their families, a psychiatric nurse practitioner researches and contributes to mental health policy development, health care reform, and practice improvement. Acquiring a Ph.D. or an Ed.D. qualifies the psychiatric nurse practitioner to work full-time as an administrator, professor, or researcher. Each state sets specific guidelines as to the exact treatment that a psychiatric nurse practitioner can and cannot administer in his or her practice.

Psychiatric nurse practitioners typically work in these areas:

  • Child and Adolescent Mental Health Nursing
  • Gerontological Psychiatric Nursing
  • Forensics
  • Substance Abuse

In a consulting liaison role, the psychiatric nurse practitioner serves patients and families dealing with complex mental and physical health issues. Another career possibility is to work in a consultant role, providing mental health insights as part of an integrative healthcare team.

Some confusion exists as to how the role of a psychiatric nurse practitioner differs from that of a psychiatrist, psychologist, or social worker. The primary difference is the academic degree: The psychiatric nurse practitioner holds a degree in nursing while the other three do not, even though their duties may sometimes overlap. But just because they sometimes have identical responsibilities does not mean the jobs are the same. Although individuals in these positions all perform psychotherapy, only a psychiatrist and psychiatric nurse practitioner can prescribe medication. Another difference is that only a psychologist has the training necessary to perform mental health testing.

Psychiatric Nurse Practitioner: Typical Duties and Responsibilities

The psychiatric nurse practitioner, also known as a “psychiatric mental health nurse practitioner” (PMHNP), must balance many roles simultaneously to be able to offer patient care of the highest quality. Besides providing direct nursing care, a psychiatric nurse practitioner acts in other roles: patient advocate, consultant, educator, and researcher. While managing the care of his or her patients, a psychiatric nurse practitioner performs the following duties:

  • Observe behavior to determine a normal baseline for each individual patient
  • Review patient histories along with current behavior to make an accurate mental health diagnosis
  • Create a treatment plan that meets the specific needs of the client
  • Treat patients using a combination of medication, psychotherapy, and traditional medical interventions
  • Collaborate with other staff to ensure the patient receives the highest quality care
  • Offer feedback to the patient and his or her family as to the progress of treatment

A psychiatric nurse practitioner provides emotional support to clients to help them not only reach their treatment goals in a timely manner, but also to make important decisions about their lives, provided those choices are mentally sound. Nurses with this level of training help clients locate resources that allow them to make positive life changes.

Educating clients about how to care for their own basic physical and emotional needs is an essential component of this role as well. If the psychiatric nurse practitioner serves patients in inpatient settings, he or she will follow up with them as needed to ensure they are managing their mental health at an optimum level. Additionally, the nurse practitioner may have to intervene in emergency situations such as threatened suicide.

The psychiatric nurse practitioner routinely meets with other health care professionals to ensure the client’s immediate needs are being met. Caring for patients who are struggling with mental illness also presents the opportunity to evaluate current mental health policies. This type of nurse spends a good portion of his or her time researching current health care policies and advocating for improved guidelines.

Other than direct care, the advocacy role is one of the most important functions of this position. A psychiatric nurse practitioner must be prepared to meet the needs of all patients, regardless of age, gender, socioeconomic status, physical disability, religion, race, or sexual orientation. Cultural and religious heritage also becomes important when creating a patient treatment plan. Advocacy on a larger scale may mean pushing for policies that are more inclusive and culturally sensitive.

Steps to Become a Psychiatric Nurse Practitioner

One in four adults experiences mental illness each year. Nurse practitioners with a psychiatric focus can help patients suffering from problems such as depression, bipolar disorder, schizophrenia, and other mental issues. These nurses, known as “psychiatric mental health nurse practitioners,” are trained to function much like a medical doctor. PMHNPs can develop a treatment plan, diagnose symptoms, and prescribe medication. Psychiatric mental health nurse practitioners play an important role in the lives of clients with mental health issues. Indeed, in geographic areas where psychiatrists are unavailable, mental health nurse practitioners may fulfill the role of a psychiatrist, conducting a private practice that meets all state regulations and provides a level of care similar to that of a doctor.

The mental health field is not a common focus for many practicing nurse practitioners; in fact, only about 3 percent of nurse practitioners choose to practice in this field. While many PMHNPs enjoy the fulfillment of helping those suffering from mental illness, others are drawn to the field for the lucrative pay. With an average yearly income of more than $110,000, the mental health nurse practitioner position is one of the highest-paying nurse practitioner jobs available.

Years of dedicated focus and study qualify an individual to work as a mental health nurse practitioner. Mental health nurse practitioners must have these qualifications before they can practice:

  • At least two degrees or certificates from an accredited educational facility;
  • Registered nurse credentials; and
  • Have completed 500 supervised hours.

1. Earn a Bachelor of Science in Nursing (BSN)

Nurse practitioners must hold advanced degrees. While nurse practitioners all end their education with graduate-level work, most begin by pursuing a bachelor’s degree in nursing (BSN). In this program, aspiring nurses study the foundations of nursing, microbiology, anatomy, nutrition, public health, physiology, health assessment, evidence-based practice, and public health. By completing continuing education courses throughout their career, students also learn the value of staying up to date with the most current nursing trends as well as advances in technology.

Students must learn how to communicate effectively with both their patients and doctors, and they also must learn leadership, critical-thinking, and problem-solving skills. This multi-faceted training helps nurses acquire the flexibility they will need to perform effectually on an everyday basis. While pursuing their BSN, students not only learn nursing theories but also the real-world skills to help them serve patients in clinical settings. In addition, student nurses fulfill clinical observation hours that help them develop a better understanding of the nursing profession.

2. Pass the National Council Licensure Examination (NCLEX-RN)

The NCLEX-RN is an examination administered to students who have graduated from the BSN program. Nurses must pass this exam to work as a registered nurse in every state in the United States and the U.S. territories. The NCLEX-RN exam is a computer-generated exam administered by a non-profit organization, the National Council of State Boards of Nursing (NCSBN). The NCSBN works with nursing boards throughout the country to regulate nursing standards and promote the nursing profession.

The NCLEX-RN exam is designed to evaluate a student’s understanding of nursing competencies and the processes fundamental to the practice of nursing. The purpose of the exam is to ensure that nurses all over the country are held to a high standard of excellence. The exam is divided into four categories and six sub-categories, which include:

  • Physiological Adaptation
  • Pharmacological and Parenteral Therapies
  • Reduction of Risk Potential
  • Basic Care and Comfort
  • Physiological Integrity
  • Safe and Effective Care Environment
  • Safety and Infection Control
  • Psychosocial Integrity
  • Management of Care
  • Health Promotion and Maintenance

To find out more about the NCLEX exam, consult the NCSBN website. Here, you can find information about registration, preparation, exam schedules, and more.

Once a student passes the exam, he or she must work as a registered nurse for at least two years before applying to a psychiatric mental health nurse practitioner program. Graduate-level PMHNP programs look for students who have real-world experience in the profession, ideally in mental-health facilities. During their two years of working as an RN, nurses should try to gain experience with patients suffering from mental illnesses as well as with special populations such as children, families, and seniors.

3. Earn a Master’s, Postgraduate, or Doctoral Degree

Earning a Master of Science, post-graduate degree, or a doctorate from an accredited institution is the next step toward becoming a practicing psychiatric mental health nurse practitioner. During graduate or post-graduate studies, prospective mental health nurse practitioners acquire the knowledge they need to practice independently or collaboratively in a variety of medical settings. Students are taught both theoretical- and evidence-based lessons that help them develop the critical-thinking and problem-solving skills necessary to work in real-world settings. In master’s programs, which usually require two years to complete, students take a range of core and specialty courses while also completing clinical work in a participating medical facility.

Advanced practice registered nurses (APRNs) who want to go on to become PMHNPs sometimes acquire a graduate-level certificate from an accredited post-master’s program. These programs typically have strict requirements as to both the amount of experience and type of coursework required to qualify for enrollment.

In some cases, students complete a bachelor’s or a master’s degree and then enter a Doctor of Nursing Practice program with an emphasis on psychiatric and mental health nursing. These programs take at least three years to complete, and students must be a practicing registered nurse to qualify for entrance. These doctoral programs often prefer students who have work experience in mental health or psychiatric facilities, work that may help gain acceptance to the program.

In these programs, students learn a variety of important skills, including how to diagnose and treat mental illnesses. Students also learn various approaches to therapy, such as group therapy, cognitive behavioral therapy, and others. A typical program focuses on helping students learn leadership, collaboration, communication, and problem-solving within clinical settings. Programs also teach ethical principles that affect PMHNPs in clinical settings. Students graduate from these programs with an improved ability to make decisions, solve problems, and work with patients, doctors, and other medical staff.

Psychiatric Nurse Practitioner Program Goals and Objectives

The primary goal of a psychiatric mental health nurse practitioner program is to prepare students for the types of real-life situations they will encounter on a daily basis in a variety of clinical settings. Upon graduation, students interact with patients experiencing a variety of mental health problems, from substance abuse to depression. PMHNPs must be able to diagnose illness, administer therapy, and prescribe medications. Patients of varying ages will undergo treatment, sometimes in group settings, so a psychiatric mental health nurse must learn to be flexible in her approach.

Essential Skills & Knowledge

Students who graduate from a PMHNP program must have theoretical- and evidence-based training to be successful on the job. In addition, they must have the ability to communicate with patients. Clear communication helps the nurse practitioner successfully explore the symptoms that a patient is experiencing and make an appropriate diagnosis.

Psychiatric mental health nurse practitioners must possess empathy and compassion to help patients develop the trust that makes therapy and treatment possible. PMHNPs must be capable of working independently, as many have private practices. Finally, psychiatric mental health nurse practitioners benefit from the ability to think critically and objectively assess situations. Remaining dispassionate and composed helps them make a diagnosis and shape mental health policy.

Typical MSN Clinical Coursework, Content, & Training

Students who enroll in a graduate-level psychiatric-mental health nurse practitioner program can expect to take courses covering a range of topics, including mental health and aging, neurophysiology, cognitive behavioral strategies, mental disorders, physiology, pathophysiology, psychological development, pharmacology, physical assessment, and environmental stressors.

This comprehensive course of study gives students the foundation upon which they can make tough decisions and act independently on the job in a clinical setting.

4. Get Board Certified Through the American Nurses Credentialing Center (ANCC)

Upon graduation from a master’s, post-graduate, or graduate program, the nurse practitioner must become certified by the American Nurses Credentialing Center (ANCC). The PMHNP-BC examination assesses the nurse’s ability to apply the knowledge gained through his or her years of training. Ultimately, this assessment proves the nurse’s ability to work as a capable and competent PMHNP.

However, prior to sitting for the exam, the nurse must fulfill a number of requirements, including two years of practice as a full-time registered nurse, 30 hours of relevant continuing education completed within a span of three years, and a minimum of 2,000 hours of clinical practice over a two-year period.

This credential is accepted all over the United States. Students who take the exam prove they possess an in-depth understanding of the type of information required to perform effectively on the job. A standardized exam helps ensure that all students are held to the same standard, and it helps ensure patients will receive the same standardized care nationwide.

5. Search for Jobs and Enter the Workforce

Upon graduation, many psychiatric mental health nurse practitioners seek work in hospitals, private practices, and agencies that deal with patients suffering from mental health problems. Many psychiatric mental health nurse practitioners work in settings such as community mental health centers, state in-patient or outpatient psychiatric facilities, correctional facilities, Veterans Administration psychiatric facilities, and domestic violence shelters.

To ensure a job awaits them after graduation, many psychiatric mental health nurse practitioners begin their job search while still attending class. Nurse practitioners who begin networking, preparing their resume, and practicing for interviews before they graduate are poised to begin work as soon as they receive their diploma.

To ensure the job is right for them, PMHNPs should research each facility before even accepting an interview. Candidates should know the populations that the facility treats, typical diagnoses, and the treatment methods favored by that facility.

Since communication skills are an important part of the job, when preparing for an interview, nurses must communicate clearly and intelligently, demonstrating their psychiatric nursing knowledge as well as their clinical expertise. Psychiatric mental health nurse practitioners who experience difficulties in communicating at an optimal level should role-play a mock interview prior to their appointment.

While the psychiatric mental health nurse practitioner niche may be small, it’s a necessary role. Nurses with an advanced degree interested in helping patients suffering from mental health problems can find a rewarding career in this field. Through hard work, dedication, and persistence, psychiatric mental health nurses can enjoy a fulfilling career, helping vulnerable members of the population with enormous needs.

Psychiatric Nurse Practitioner Salary and Job Outlook

According to the website Healthcare Salaries, in 2013, the median salary for a psychiatric nurse practitioner in the United States was $91,106. The career website PayScale lists a salary of $97,800 in 2016, indicating that the average pay has remained stable. PayScale also reports a salary range of $71,485 to $129,837 when bonuses and profit-sharing are factored into the equation.

At 31 percent, the demand for nurse practitioners in all specialties is exceptionally high. As individuals and families continue to face mental health challenges in an increasingly stressful society, the demand for psychiatric nurse practitioners is expected to comprise a large part of this demand. The projected increase is also based on the health insurance mandate passed under the Obama administration, which provides resources to medical care that many individuals with mental health issues previously lacked. Seeking help for mental health issues is less stigmatized than it was in the past, another factor contributing to the expected increase in available positions for the psychiatric nurse practitioner.